小结
定义
病史和体格检查
关键诊断因素
- dermatitis
- insomnia, depression, or memory loss
- intermittent stupor
- hallucinations or delirium
- weakness
- peripheral neuropathy
- oppositional hypertonus or myoclonus
- cogwheel rigidity
- primitive reflexes
- ataxia
- nausea, vomiting, or diarrhea
- glossitis, cheilitis, or stomatitis
其他诊断因素
- fatigue
- anxiety or paranoia
- anorexia, weight loss, or cachexia
- headache
- vertigo
- incontinence
- constipation
- heartburn
- angular palpebritis
危险因素
- malnutrition
- chronic alcohol use disorder
- vitamin B2 (riboflavin) deficiency
- vitamin B6 (pyridoxine) deficiency
- malabsorption
- eating disorders
- Hartnup disease
- carcinoid syndrome
- antituberculous drugs
- Crohn disease
- HIV infection
- copper deficiency
- certain drugs
- pregnancy and lactation
- age >65 years
- Alzheimer disease
- Parkinson disease
诊断性检查
首要检查
- serum tryptophan
- urinary N-methylnicotinamide
- urinary N-methyl-2-pyridone-5-carboxamide
- urinary 2-pyridone/N-methylnicotinamide ratio
- skin biopsy
- photosensitivity testing
- CBC
- serum albumin
- serum protein
- LFTs
- gamma-GT
需考虑的检查
- serum total iron
- iron-binding capacity
- ferritin
- transketolase activity
- thiamine pyrophosphate (TPP)
- riboflavin coefficient
- serum pyridoxal-5-phosphate
- serum cyanocobalamin
- serum folic acid
- red cell folic acid
- stool exam
- neutral aminoaciduria
- serum serotonin
- platelet serotonin
- urinary 5-hydroxyindoleacetic acid
- HIV antibodies
- mental state exam
- ECG
治疗流程
asymptomatic (marginal deficiency)
symptomatic (pellagra)
撰稿人
作者
Whadi-ah Parker, PhD, RD(SA)
Senior Research Specialist
Centre for the Study of the Social and Environmental Determinants of Nutrition
Population Health, Health Systems and Innovation
HSRC
Cape Town
South Africa
利益声明
WP declares that she has no competing interests.
Zandile J Mchiza, RD, PhD
Professor
School of Public Health
University of the Western Cape
Cape Town
South Africa
利益声明
ZJM declares that she has no competing interests.
鸣谢
Dr Whadi-ah Parker and Dr Zandile J Mchiza would like to gratefully acknowledge Dr Demetre Labadarios and Dr Nelia Patricia Steyn, as previous contributors of this topic, as well as Miss Nophiwe Job, Ms Nwabisa Tshefu, and Mr Machoene Derrick Sekgala for their contributions to this topic. DL, NPS, NJ, NT, and MDS declare that they have no competing interests.
同行评议者
Alan Shenkin, MB, ChB, BSc, PhD, FRCP, FRCPath
Emeritus Professor of Clinical Chemistry
University of Liverpool
UK
利益声明
AS declares that he has no competing interests.
Alfredo Morabia, MD, PhD, MS
CBNS
Queens College
City University of New York
NY
利益声明
AM declares that he has no competing interests.
鉴别诊断
- Dermatitis
- Diarrhea
- Dementia
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